CAR: Bringing Vaccinations and Other Services to Children in Remote, Troubled Areas

MSF teams in the Gadzi area of CAR have been vaccinated children for measles and polio while also providing other crucial medical services for people displaced by violence.

Doctors Without Borders/Médecins Sans Frontières (MSF) teams in Central African Republic (CAR) carried out an emergency intervention in the region of Gadzi, vaccinated some 9,000 children against measles and polio in an area where the population had very limited access to health facilities and services. Children younger than five also received vitamin A supplements and were de-wormed.

The intervention in Gadzi is one of four emergency projects MSF opened in the country last April, when a coup by the armed Séléka coalition plunged the country into political and social turmoil and drove nearly 300,000 people from their homes.

In addition to the vaccination campaign, MSF teams working in seven health centers in the area have carried out more than 5,000 medical consultations, more than half of them for malaria. Other pathologies treated are common to displaced populations: respiratory infections, water-borne diseases (intestinal parasites), or skin infections.

Endemic Malaria

Malaria is one of the main concerns of the MSF teams working in CAR. Endemic in the country, it is one of the leading causes of mortality. In Gadzi alone, 77 patients had to be admitted because of severe malaria, or malaria combined with other pathologies, and 56 had to be referred to hospitals with more resources because of the seriousness of their condition.

The emergency intervention also included a nutritional component due to concerns that displacement might bring about food shortages, particularly among young children. Staff admitted 151 children as outpatients and provided them with supplementary food supplies. Nineteen required admission since their malnutrition was aggravated by other conditions such as measles or malaria.

The vaccination campaign was also used to evaluate children’s nutritional status. Although it was only undertaken in Topia due to access difficulties related to poor roads, the onset of the rainy season, and the lack of security due to the presence of combatants in the area, it managed to cover 96 percent of the children initially targeted.

Training and Treatment Together

Throughout the intervention, medical and non-medical staff has been trained to treat the most common diseases in the area, including acute malnutrition. The team also donated medicines, therapeutic food, and medical supplies. Children requiring intensive nutritional treatment are referred to the MSF-supported hospital in the neighboring town, Carnot.

MSF has scaled up its activities in the area and has been urging the international community to provide more support and aid for the population in CAR. It is one of the world’s poorest countries; life expectancy is just 48 years. And its future has grown even more uncertain given recent political events.

Emergency After Emergency

The end of the vaccination campaign in Gadzi coincides with the reopening of another emergency project in Bouca, in the north, where the teams had to be evacuated after being threatened by armed groups controlling the area. The teams witnessed attacks against the population on September 9, in a new wave of violence affecting Bouca and the neighboring area of Bossangoa.

Presumed supporters of the recently overthrown president François Bozizé and of Séléka were responsible for attacks against civilians that involved mass executions and the burning of entire neighborhoods. MSF has repeatedly condemned these incidents.

After obtaining security guarantees from the current transition government, teams have returned to Bouca, where the project also focuses on mother and child health care and emergency cases.

MSF operates two other emergency projects in Bossangoa and Bria, while running regular projects in Zemio, Boguila, Paoua, Carnot, Kabo, Batangafo, and Ndélé.